Tees Wide Mental Health Training Hub Application Form
By clicking submit you consent for information provided to be held on computer and other relevant filing systems and shared with your employer and accredited organisations and agencies in accordance with the Data Protection Act 1998 and the General Data Protection Regulation. You understand that the data will be used for the purposes of administration, monitoring of training provision, statistical purposes and we may email you information about professional events and other training courses.

Applicants will be notified by email when possible within 14 days if their application has been successful (please do not assume you have a place until you have been notified). Please note that a recharge is in place for course cancellations and no-shows (£45 per day for no shows and cancellations made less than one week before).

Date of Application
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Full Name *
Your answer
Job Title or Volunteer/Placement Role *
Your answer
Team/Service *
Your answer
Organisation *
Your answer
Workplace or Home Address *
Your answer
Workplace or HomeTelephone Number *
Your answer
Workplace or Home Email Address
Your answer
Line Managers Name (if applicable) *
Your answer
Line Managers Telephone Number (if applicable) *
Your answer
Line Manager Email Address (if applicable)
Your answer
Reason for application: *
Your answer
Special requirements we need to be aware of
e.g. access, learning support, communication
Your answer
Course Name
Course location
Course Start Date
MM
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DD
/
YYYY
Which Sector does your Organisation operate in? *
Do you work in Youth or Adult Services? *
How did you hear about this course *
Is this a Refresher Course *
Required
If yes was this training provided by the Teeswide Training Hub
We value your privacy. We’ll never share your data with others without your permission and we’ll only use it for the purposes we’ve outlined and you’ve agreed to. Please see our Privacy Policy (the link is contained in the footer below). If at any time in the future you do not wish us to contact you, please email us at info@rcmind.org putting UNSUBSCRIBE in the heading or telephone us on 01642 296052
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